BMC Nephrology最新文献

{"title":"Factors influencing the symptom-to-contact time in patients with peritoneal dialysis-associated peritonitis: a multi-center retrospective study.","authors":"Huimin Huang, Yan Luo, Meirong Lv, Qing Liao, Juanjuan Ou, Cuirong Hu","doi":"10.1186/s12882-025-04439-y","DOIUrl":"10.1186/s12882-025-04439-y","url":null,"abstract":"<p><strong>Background: </strong>Delays in seeking medical attention cause delays in the initiation of antibiotic therapy, prolonging the duration of illness in patients with peritoneal dialysis-associated peritonitis (PDAP). However, there is limited information on the factors that cause delays in seeking initial medical attention after the onset of symptoms. This study aims to investigate the situation and factors influencing delayed consultation in PDAP patients.</p><p><strong>Methods: </strong>Retrospective review of clinical and epidemiological data of all adult patients with peritoneal dialysis-associated peritonitis in three hospitals in Xiamen, China, who developed peritonitis between January 2022 and November 2024. Data were analysed with descriptive and inferential statistics (i.e. correlation and multiple logistic regression) using the Statistical Package for the Social Sciences version 27.</p><p><strong>Results: </strong>A total of 134 patients were included in the current study, of whom 77 (57.5%) had symptom-to-contact time (SC time) ≦ 24 h. Cloudy effluent was the most common presenting symptom (73.9%), while 67.9% had abdominal pain and 53% had both. Univariate analysis showed that there was a statistically significant difference between groups in residence (χ2 = 10.059, P = 0.002), PD modality (χ2 = 7.151, P = 0.007), fever (χ2 = 10.631, P = 0.001), abdominal pain (χ2 = 13.206, P < 0.001), cloudy effluent (χ2 = 8.002, P = 0.005), and diarrhea (χ2 = 4.953, P = 0.026). Univariate logistic regression analysis demonstrated that Residence(OR = 2.54, 95% CI:1.09-5.94, p = 0.032)、PD modality(OR = 0.06, 95% CI:0.01-0.87, p = 0.039)、Abdominal pain(OR = 4.60, 95% CI:1.87-11.32, p = 0.001)、Fever(OR = 4.34, 95% CI:1.24-15.17, p = 0.022)、Diarrhea(OR = 0.26, 95% CI:0.07-0.94, p = 0.040)are factors affecting the SC time in patients with peritoneal dialysis-associated peritonitis.</p><p><strong>Conclusion: </strong>A substantial proportion of PDAP patients experienced delayed consultation. Specifically, residence, PD modality, abdominal pain, fever, and diarrhea were the influencing factors for delayed consultation in PDAP patients. Targeted interventions in managing PDAP patients are therefore important to promote timely consultations, particularly in rural areas, by improving patient awareness and education. They should also enhance the accessibility of healthcare services and provide clear guidance on when to seek medical attention.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"517"},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of SAA1 in mediating renal fibrosis through TLR4-dependent NF-κB activation.","authors":"Xiao Wei, Lixiang Feng, Yuan Yuan, Qihui Kuang, Hong Yu, Jun Yang, Xiong Wang, Pengcheng Luo","doi":"10.1186/s12882-025-04438-z","DOIUrl":"10.1186/s12882-025-04438-z","url":null,"abstract":"<p><strong>Background: </strong>Renal fibrosis is a key and irreversible pathological event in the progression of chronic kidney disease (CKD), and inflammatory response plays an important role in this process. Serum amyloid A1 (SAA1), an acute-phase reactant protein, which plays an important role in inflammation as a cytokine; but its specific role in renal fibrosis remains to be studied.</p><p><strong>Methods: </strong>In this study, SAA1 and TLR4 knockout mice were used to establish unilateral ureteral obstruction (UUO) animal renal fibrosis model, and HK-2 cells were used to establish TGF-β-induced cell fibrosis model. The specific role of SAA1 in renal fibrosis was explored by immunoblotting and immunohistochemistry. Subsequently, this study used molecular docking and Co-Immunoprecipitation to verify the specific mechanism of SAA1 promoting renal fibrosis progression.</p><p><strong>Results: </strong>We found that SAA1 levels were significantly increased in both in vivo and in vitro fibrosis models. Functional studies have shown that gene knockout or knockdown of SAA1 can significantly reduce the progression of renal fibrosis and limited fibrin deposition. On the contrary, overexpression of SAA1 in HK-2 cells aggravated the process of fibrosis. At the mechanism level, we found that in HK-2 cells, SAA1 can directly bind to TLR4, activate downstream NF-κB signaling pathway, promote the production of various cytokines, and then promote the progress of renal fibrosis. Importantly, knockdown of TLR4 alleviated this process.</p><p><strong>Conclusions: </strong>This study demonstrates that SAA1 promotes the progression of renal fibrosis through TLR4/NF-κB signaling pathway.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"518"},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a new CD46 gene mutation site in a family with atypical hemolytic uremic syndrome.","authors":"Benjin Hu, Xu Wang, Xian Wang, Hongchuan Zhang, Dongdong Mei, Xiaohua Guo, Xiaowei Li","doi":"10.1186/s12882-025-04458-9","DOIUrl":"10.1186/s12882-025-04458-9","url":null,"abstract":"<p><strong>Background: </strong>Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy resulting from the dysregulation of the alternative complement pathway. Pathogenic variants in complement regulators (e.g., CFH, CFI, CD46, THBD), effectors (C3, CFB), CFHR genes, and non-complement genes (e.g., DGKE, INF2), as well as anti-factor H autoantibodies, play significant roles in disease pathogenesis. Furthermore, numerous CFH-CFHR hybrid genes are increasingly recognized as significant contributors to aHUS pathogenesis. Among these, epidemiological data on CD46-associated aHUS remain limited. Here, we present a case of aHUS associated with a rare novel homozygous mutation in the CD46 gene (c.1127 + 2T > A).</p><p><strong>Case presentation: </strong>We present a case of a 27-year-old Chinese male diagnosed with atypical Hemolytic Uremic Syndrome (aHUS) at the age of 8, who has experienced seven relapses over a span of 19 years. Whole-exome sequencing (WES) revealed a novel homozygous mutation in the CD46 gene (c.1127 + 2T > A; intron 12 splice site), which is classified as pathogenic according to ACMG guidelines and has not been previously reported. Sanger sequencing confirmed the presence of this variant. Further analyses demonstrated significantly reduced CD46 mRNA and protein expression in the patient's peripheral blood compared to healthy controls and his mother, as assessed by qPCR and ELISA.</p><p><strong>Conclusion: </strong>In our study, a novel mutation in the CD46 gene (c.1127 + 2T > A) was identified via WES and confirmed to affect the transcription and translation of CD46, thereby contributing to the pathogenesis of aHUS. This finding broadens the spectrum of CD46 gene variants associated with aHUS, providing a critical basis for clinical diagnosis, genetic counseling, and treatment.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"516"},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: An explainable machine learning model for early warning of hypertensive and hypotensive anomalies in maintenance hemodialysis patients.","authors":"Zhuoyu Li, Siying Hao, Shujun Shi, Lin Li, Ziwei Tao","doi":"10.1186/s12882-025-04447-y","DOIUrl":"10.1186/s12882-025-04447-y","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"515"},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of dual glomerular pathology: Alport syndrome and immune complex-mediated MPGN.","authors":"Seyda Gul Ozcan, Eylul Koc, Ahmet Murt, Mevlut Tamer Dincer, Iclal Gurses, Nurhan Seyahi, Sinan Trabulus","doi":"10.1186/s12882-025-04400-z","DOIUrl":"10.1186/s12882-025-04400-z","url":null,"abstract":"<p><strong>Background: </strong>Immune complex-mediated membranoproliferative glomerulonephritis (IC-MPGN) and Alport syndrome are distinct glomerular diseases with different pathophysiologic mechanisms. Their coexistence is extremely rare and may present diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>A 42-year-old woman presented with persistent proteinuria and hematuria. Initial laboratory evaluations showed a progressive increase in proteinuria. She had a family history of renal disease. A renal biopsy, which had initially been postponed on patient request, subsequently revealed diffuse mesangial and focal endocapillary proliferation, GBM thickening, periglomerular fibrosis, and immune complex deposition with IgM, C3, and C1q, thereby confirming the diagnosis of IC-MPGN. Genetic testing identified a heterozygous COL4A5 c.1871G > A (p.Gly624Asp) mutation consistent with X-linked Alport syndrome. The patient follows conservative management now.</p><p><strong>Conclusion: </strong>This case highlights the rare coexistence of IC-MPGN, chronic TIN and Alport syndrome. In patients with progressive glomerular disease, especially with a family history of renal disease or extrarenal findings, genetic evaluation should be considered. Early renal biopsy and genetic testing are essential to guide management in complex cases with overlapping features.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"514"},"PeriodicalIF":2.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant proteinuria as a predictor of renal prognosis in malignant hypertension patients with thrombotic microangiopathy: a prospective cohort study.","authors":"Wanxin Shi, Xingji Lian, Wenchuan Li, Rong Lian, Shengyou Yu, Zefang Dai, Zhong Zhong, Yiqin Wang, Wei Chen, Jianbo Li, Feng He","doi":"10.1186/s12882-025-04407-6","DOIUrl":"10.1186/s12882-025-04407-6","url":null,"abstract":"<p><strong>Background: </strong>Malignant hypertension (mHTN) is the most severe form of hypertension. Thrombotic microangiopathy (TMA) serves as both a complication of mHTN and a contributor to its progression by exacerbating renal damage. Proteinuria is a common manifestation of mHTN. However, the impact of proteinuria on renal prognosis in mHTN patients with TMA is unclear.</p><p><strong>Methods: </strong>This observational cohort study included 276 mHTN-associated TMA patients based on renal biopsy from 2008 to 2023. Demographic characteristics, laboratory results, and histopathological findings were recorded and compared between the mild (< 1 g / 24 h) and significant (≥ 1 g / 24 h) proteinuria groups. Propensity score matching (PSM) was used to adjust for baseline differences. Cox regression model was employed to evaluate risk factors associated with renal prognosis.</p><p><strong>Results: </strong>Among the 276 patients included in the study, 185 (67.0%) had significant proteinuria, while 91 (33.0%) had mild proteinuria at baseline. After PSM, 83 pairs of patients with mHTN-associated TMA were matched. Patients with significant proteinuria exhibited lower serum albumin, and higher ratio of global sclerosis compared to patients with mild proteinuria. Moreover, mHTN-associated TMA with significant proteinuria was independently associated with receiving renal replacement therapy (RRT) (adjusted hazard ratio (aHR), 1.30; 95% confidence interval (CI), 1.16-1.46; P < 0.001) compared with mild proteinuria. This association remained significant after PSM (aHR, 1.29; 95% CI, 1.13-1.47; P < 0.001). Furthermore, mHTN-associated TMA patients with significant proteinuria had a lower incidence of renal function recovery with a reduction in creatinine levels than in patients with mild proteinuria in the absence of intensive blood pressure control.</p><p><strong>Conclusion: </strong>In mHTN-associated TMA patients, the presence of significant proteinuria serves as a strong predictor of poor renal outcome.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"513"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the relationship between intravenous iron therapy and troponin T levels in hemodialysis patients: a cross-sectional study.","authors":"Marah Hunjul, Diana Owda, Bayan Sawaid, Heba Saadeh, Ahmad Enaya, Zakaria Hamdan, Zaher Nazzal","doi":"10.1186/s12882-025-04436-1","DOIUrl":"10.1186/s12882-025-04436-1","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"510"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and advances in mouse models of diabetic nephropathy: a narrative review.","authors":"Kang Xie, Yan Ma, Jingjing Din, Yujie Jin, Siwen Zhang, Shiqiang Liu, Cui Yu, Xu Wu, Chunyan Xing, Lizhuo Wang, Jialin Gao","doi":"10.1186/s12882-025-04432-5","DOIUrl":"10.1186/s12882-025-04432-5","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"511"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a nomogram for predicting hyperphosphatemia in non-dialysis patients with chronic kidney disease.","authors":"Xianhui Zhao, Caiyun Zheng, Qitong Su, Dongli Lu, Shiqin Wu, Zhenghua Jiang, Zhaochun Wu","doi":"10.1186/s12882-025-04445-0","DOIUrl":"10.1186/s12882-025-04445-0","url":null,"abstract":"<p><strong>Background: </strong>Elevated serum phosphate levels are strongly associated with an increased risk of all-cause mortality in patients with chronic kidney disease (CKD). The aim of this study was to identify independent risk factors for hyperphosphatemia in patients with non-dialysis CKD and use the findings to develop and validate a predictive model for assessing hyperphosphatemia risk.</p><p><strong>Methods: </strong>Data of patients with CKD discharged from the Department of Nephrology between January 2021 and December 2023 were retrospectively analyzed. Potential predictors were screened from an array of clinical variables using least absolute shrinkage and selection operator regression in conjunction with 10-fold cross-validation. A multivariate logistic regression model was constructed to identify independent risk factors for predicting hyperphosphatemia. The C-index, receiver operating characteristic curve, calibration curve, and decision curve analysis were used to evaluate model predictive power, discriminability, accuracy, and clinical utility. Internal validation was implemented through a comparison of results from a validation set and the entire dataset.</p><p><strong>Results: </strong>This study included 216 patients, with 134 (62.04%) individuals who developed hyperphosphatemia. Logistic regression revealed that hemoglobin, blood urea nitrogen, serum creatinine, and parathyroid hormone were independently correlated with hyperphosphatemia. The nomogram C-index was 0.916 (95% confidence interval [CI]: 0.872-0.961). The model demonstrated excellent discriminative ability in the independent validation set (area under the curve [AUC] = 0.953, 95% CI: 0.909-0.998), with the full dataset analysis showing concordant results (AUC = 0.923, 95% CI: 0.889-0.958). The decision and clinical impact curves showed the clinical value of our nomogram for patients with CKD and hyperphosphatemia.</p><p><strong>Conclusions: </strong>The nomogram model was highly accurate in identifying CKD subpopulations at an elevated risk of serum phosphorus metabolic disorders. Our model can be utilized for prospective monitoring and preventive intervention. Furthermore, through individualized risk assessments, the model can contribute to the development of customized treatment strategies that have the potential to markedly improve long-term prognosis.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"512"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentation of post-streptococcal glomerulonephritis in a child with genetically confirmed susceptibility to C3-glomerulopathy: a case report and brief review of the literature.","authors":"Charalampos Kapogiannis, Anastasios Kapogiannis, Diagoras Zarganis, Harikleia Gakiopoulou, Andreas Fretzayas","doi":"10.1186/s12882-025-04437-0","DOIUrl":"10.1186/s12882-025-04437-0","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"505"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}